1887
Volume 2006, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

A prospective observational study at the newly estab-lished Fetal Medicine Unit, Hamad Hospital, Qatar; evalu-ated the impact of the service on the detection rate of criti-cal congenital heart defects, patterns of referral and sub-sequent yield for structural congenital heart disease in a population with a significant proportion of high risk fac-tors.

Of 391 pregnant females examined between January 2003 and December 2004, 58 (14.8%) had fetal cardiac abnormalities of which 23 (5.8% of total referrals) had major structural malformations of the heart. Cases of fetal congenital heart disease had further evaluation us-ing real time three-dimensional echocardiography (RT3DE) which is new equipment in the paediatric cardi-ology department. All cases with cardiac defects whether minor or major had follow up fetal echocardiography. Neonatal echocardiography confirmed the diagnosis in all cases with major defects (100% specificity). False positive cases that were found to be normal post natal were 1% of the total cases referred (12% of cases with congenital mal-formation). False negative cases were 1% and all had a small ventricular septal defect (VSD) except for one Down's syndrome with a very large VSD.

Three patients needed urgent Caesarean section (CS) deliveries, one with complete heart block (HB) and two with supraventricular tachycardia (SVT). One patient traveled abroad as the fetus had left isomerism and major cardiac defects and complete HB. Fifteen newborns had to receive prostaglandin based on the fetal diagnosis before being seen by paediatric cardiologists. There was no termination of pregnancy due to major cardiac defects even in cases of HLHS.

The preliminary results of this clinic are very satisfac-tory and have affected favorably the outcome of the new-borns with congenital heart defects. It is hoped that the results of this study will encourage more referrals to the FMU.

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References

  1. Hoffman JIE. Incidence of congenital heart disease. Postnatal incidence. Pediatr Cardiol. 1995; 16::103113.
    [Google Scholar]
  2. Abu-Harb M, Hey E, Wren C. Death in infancy from unrecog-nized congenital heart disease. Arch Dis Child. 1994; 71::37.
    [Google Scholar]
  3. Young ID, Clarke M. Lethal malformations and perinatal mortality: A ten year review with comparison of ethnic differences. BMJ. 1987; 295::8991.
    [Google Scholar]
  4. Keith JD, Rowe RD, Vlad P. Heart Disease in Infancy and Childhood. 3rd Edition. New York: Macmillan 1978:p.9.
  5. Nora JJ, Hart-Nora A. The genetic contribution to congenital heart diseases. In: Nora JJTakao A, eds. Congenital Heart Disease: Causes and Processes. Mt Kisko. New York: Futura Publishing 1984;:313.
    [Google Scholar]
  6. Wladimiroff JW, Stewart PA, Vosters RPL. Fetal cardiac struc-ture and function as studied by ultrasound. A review. Clin Cardiol. 1984; 7::239253.
    [Google Scholar]
  7. Copel J A, Cullen M, Green JJ, Mahoney MJ, Hobbins JC, Kleinman CS. The frequency ofaneuploidy in prenatally diagnosed congenital heart disease: an indication of fetal karyotyping. Am J Obstet Gynecol. 1988; 158::409413.
    [Google Scholar]
  8. Buskens E, Grobee DE, Frohn-Mulder IME, Wladimiroff JW, Hess J. Aspects of aetiology of congenital heart disease. Eur Heart J. 1995; 16::584587.
    [Google Scholar]
  9. Chang AC, Huhta JC, Yoon GY, et al., Diagnosis, transport and outcome in fetuses with left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg. 1991; 102::841848.
    [Google Scholar]
  10. Nora JJ, Nora AH, Wexler P. Hereditary and environmental aspects as they affect the fetus and the newborn. Clin Obstet Gynecol. 1981; 24::851861.
    [Google Scholar]
  11. Gembruch U. Prenatal diagnosis of congenital heart disease. Prenat Diagn. 1997; 17::12831298.
    [Google Scholar]
  12. Isaacs H Jr. Fetal and neonatal cardiac tumors. Pediatr Cardiol. 2004 May-Jun; 25:3:252273.
    [Google Scholar]
  13. Crawford DC, Chita SK, Allan LD. Prenatal detection of congenital heart disease: factors affecting obstetric manage-ment and survival. Am J Obstet Gynecol. 1988; 159::352356.
    [Google Scholar]
  14. Bonnet D, Coltri A, Butera G, et al., Detection of transposition of the great arteries in fetuses reduces neonatal morbitidity and mortality. Circulation. 1999; 99::916918.
    [Google Scholar]
  15. Stiimpflen I, Stiimpflen A, Wimmer M, Bernaschek G. Effect of detailed fetal echocardiography as part of routine prenatal ultrasonographic screening on detection of congenital heart disease. Lancet. 1996; 348::854857.
    [Google Scholar]
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